I just read that placenta previa will not be included in this measure's numerator and denominator for 2018 which was one of my original issues because these patients are not candidates for vaginal delivery in the first place. My second comment is regarding patients with a history of uterine surgery such as a significant myomectomy. Why are these patients also not excluded from the measure's numerator and denominator when they have had surgery that recommends delivery by subsequent cesarean due to high risks of uterine rupture from trial of labor? While the intent of the measure is good, it seems we should be trying to accurately capture those who are actually candidates for a vaginal delivery. Other situations that would prevent a vaginal delivery would be cord prolapse, funic presentation, or as other commenters may have suggested, certain maternal medical conditions that do not allow for a trial of labor.